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Biomedical subjects

F Liaño

Publications and source records attributed to F Liaño.

At least 37 records · Page 2Linked to original sources
PubMed1996

Intradiploic epidermoid cysts.

We studied 37 intradiploic epidermoid cysts, reviewing typical and atypical radiological features and the differential diagnosis. The most common clinical feature was a long standing lump in the scalp, occurring in 25 patients (67.7%). Plain films were the most cost-effective radiological technique in diagnosis. The typical finding was a well-defined lytic lesion with sclerotic border, seen in 29 cases (78%). Atypical lesions were those larger than 5 cm and/or with an ill-defined edge, being observed in 8 cases (22%). CT and MRI were the best methods for assessing atypical ones. In all cases with typical radiological findings a preoperative diagnosis of intradiploic epidermoid cyst was suggested.

Adolescent↗
PubMed1996

Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group.

There are very limited data on overall epidemiology of ARF. It is crucial to know the incidence, etiology and clinical feature of ARF to promote prevention strategies and to implement adequate resources for the management of this entity. During a nine month period, a collaborative prospective protocol with 98 variables was developed to assess all ARF episodes encountered in the 13 tertiary-care hospitals in Madrid, Spain (covering 4.2 million people of over 14 years of age). ARF was considered when a sudden rise in serum creatinine concentration (SCr) to more than 177 mumol/liter was found in patients with normal renal function, or when the sudden rise (50% or more) was observed in patients with previous mild-to-moderate chronic renal failure (SCr < 264 mumol/liter). Of the 748 cases of ARF studied, 665 episodes presented in inhabitants from the Madrid area. This gives an overall incidence of ARF of 209 cases per million population (p.m.p.; 95% CJ 195 to 223). The incidence of acute tubular necrosis (ATN) was 88 cases p.m.p. (95% CI 79 to 97), prerenal ARF 46 p.m.p (95% CI 40 to 52), acute-onset chronic ARF 29 p.m.p. (95% CI 24 to 34), and obstructive ARF 23 p.m.p. (95% CI 19 to 27). The mean age was 63 +/- 17 years. The most frequent causes of ARF were ATN (45%), prerenal (21%), acute-onset chronic renal failure (12.7%) and obstructive ARF (10%). Renal function was normal at admission in 48% of patients who later developed ARF. Mortality (45%) was much higher than that of the other patients admitted (5.4%, P < 0.001). This real outcome correlated extremely well with the expected outcome calculated through out the severity index of ARF (SI) 0.433 +/- 0.246 (mean +/- SD). In 187 cases, mortality was attributed to underlying disease, thus corrected mortality due to ARF was 26.7%. Dialysis was required in 36% of patients, and was associated with a significantly higher SI of ARF (0.57 +/- 0.23 vs. 0.35 +/- 0.19, P < 0.001) and mortality (65.9 vs. 33.2%, P < 0.001). Mortality in patients hemodialyzed with biocompatible synthetic membranes (N = 50) was similar to that observed with cellulosic ones (N = 84; 66% vs. 59.5%, NS). Mortality was higher in patients with coma, assisted respiration, hypotension, jaundice (all P < 0.001) and oliguria (P < 0.02). This study gives, for the first time, the incidence of all forms of ARF in a developed country. ARF is iatrogenically induced at a high rate by modern medicine. Prevention strategies, particularly in the perioperative period, are needed to decrease its impact.

Acute Kidney Injury↗
PubMed1996

Effectiveness of intravenous administration of Fe-gluconate-Na complex to maintain adequate body iron stores in hemodialysis patients.

The evolution of body iron stores was prospectively analyzed during a stable erythropoiesis period in 27 subjects (14 males and 13 females) on hemodialysis for more than 2 years in order to clarify the iron requirements of these patients and the effectiveness and safety of the administration of sodium ferric gluconate as a method to maintain adequate body iron stores. All patients had a stable hemoglobin level (variation < 1 g/dl). Sixteen subjects were on maintenance recombinant human erythropoietin therapy at regular doses. All patients received intravenous sodium ferric gluconate for 6 months (62.5 mg/month). The iron requirements were estimated as the difference between the amount of iron administered and the variation of body iron stores (calculated by the empirical formula of Cook and coworkers). The hemoglobin remained stable (basal 10.7 +/- 1.1, at 6th month 10.6 +/- 1 g/dl). Considering all cases, there were no significant variations in body iron stores (basal 457 +/- 273, at 6th month 451 +/- 316 mg). The patients were classified into three groups according to whether their body iron stores decreased (group A, n = 8), remained stable (group B, n = 11), or increased (group C, n = 8). There were no differences among groups concerning sex, age, time on hemodialysis, or erythropoietin therapy. However, there were statistically significant differences concerning their basal body iron stores (group A 457 +/- 228 mg. group B 563 +/- 146, and group C 230 +/- 297 mg; p < 0.05, analysis of variance). The iron needs, considering the total group, were 2.12 +/- 2 mg/day. There were no differences in iron requirements according to sex, but menstruating women had higher iron needs than the nonmenstruating ones (4.29 +/- 2 vs. 2.08 +/- 1.45 mg/day; p < 0.01). The iron requirements in patients on erythropoietin therapy were higher than in those without (2.63 +/- 1.59 vs. 1.88 +/- 1.68 mg/day; p < 0.05). However, excluding the menstruating women, the iron need in patients on erythropoietin were similar to those in subjects without this treatment (2.16 +/- 1.13 vs. 1.88 +/- 1.68 mg/day). All patients showed good compliance with an excellent tolerance. We have observed that in subjects on maintenance erythropoietin therapy, the iron requirements are stable. The administration of sodium ferric gluconate is safe and efficient in maintaining adequate body iron stores.

Adult↗
PubMed1995

Evolution of serum erythropoietin after androgen administration to hemodialysis patients: a prospective study.

A prospective study of the evolution of serum erythropoietin level after androgen therapy was carried out in a group of 25 male patients on chronic hemodialysis treatment with nonferropenic anemia (serum ferritin > 50 ng/ml). The androgen used was nandrolone decanoate (200 mg/week intramuscularly, for 6 months). There was an increase of serum erythropoietin, that reached statistical significance in the 2nd week of treatment (8.6 +/- 6.4 vs. 14.2 +/- 9.8 mIU/ml, p < 0.05), and a stabilization after 1 month (1 month: 17.8 +/- 11.2 mIU/ml, 6 months: 19.6 +/- 14.9 mIU/ml). The hemoglobin also experienced a parallel increase to that observed in serum erythropoietin (basal value: 8 +/- 0.9 g/dl; at 1 month postandrogen: 9.2 +/- 1.3 g/dl, p < 0.001; at 6 months: 10.7 +/- 1.8 g/dl, p < 0.001). According to their response of serum erythropoietin the patients were divided into responders (15 patients) and nonresponders (10 patients). There were no differences between them concerning age, basal levels of serum erythropoietin and hemoglobin, and dose of nandrolone decanoate in relation to body weight. The evolution of hemoglobin was similar in both groups, and a correlation between serum erythropoietin and hemoglobin was not observed in the responder group. Fourteen patients were studied after androgen was discontinued. The serum erythropoietin returned to basal levels 6 weeks after the last dose of nandrolone decanoate (7.7 +/- 5.4 mIU/ml). However, hemoglobin was above the basal levels 16 weeks after discontinuing androgen (9.5 +/- 1.1 g/dl, p < 0.05), with no differences between the responder and nonresponder group.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

The elderly patient with acute renal failure.

Structural and functional changes observed in the aging kidney predispose the elderly patient to acute renal failure. Up to 36% of the patients with acute renal failure from this institution were over 70 yr, and the literature is full of similar experiences. The elderly patient with abrupt cessation of adequate renal function requires a special work-up in diagnosis and treatment. Prerenal and obstructive causes are of particular interest. Although the question of whether or not age has an independent prognostic importance during an episode of acute renal failure remains debated; when these and other authors compared the outcome of young and old populations with these disorders, a similar evolution was always observed. Age should not be used as a discriminant factor in therapeutic decisions concerning acute renal failure.

Acute Kidney Injury↗
PubMed1994

Tumour lysis syndrome after treatment of chronic lymphocytic leukaemia with fludarabine.

Fludarabine is one of the most recent and promising therapeutic agents for chronic lymphocytic leukaemia. We describe a patient who developed tumour lysis syndrome after the first course of treatment with fludarabine and call attention to this uncommon but potentially lethal complication that has not been previously taken into account in this neoplasia. It should always be anticipated when patients are treated with new and effective drugs.

Antineoplastic Agents↗
PubMed1994

Use of urinary parameters in the diagnosis of total acute renal artery occlusion.

Limited attention has been paid to the composition of the small amounts of urine that are frequently produced by patients with acute renal failure (ARF) of vascular origin. We have investigated the value of basic urinary parameters in the early diagnosis of total or partial acute renal artery occlusion (ARAO). We have reviewed the records of 30 patients with ARF: group 1 (n = 10) had total ARAO; group 2 (n = 10) had unilateral ARAO with a contralateral functioning kidney, and group 3 (n = 10) had hemodynamically mediated ARF subsequent to a major vascular abdominal surgical procedure, without arterial thrombosis. Serum sodium, potassium, urea, creatinine and osmolality, as well as urinary sodium, potassium, urea, creatinine and osmolality, were determined by standard techniques, and the fractional excretion of sodium (FENa) was calculated. Serum parameters were similar in all groups. Urinary sodium and FENa were higher in group 1 than in the other groups (p < 0.01), while urinary potassium was lower (p < 0.05). Urinary urea (p < 0.01) and osmolality (p < 0.05) were higher in group 2 than in the other groups, revealing a prerenal pattern in some cases. Serum and urinary concentrations of sodium, urea and creatinine and osmolality were similar in group 1, while respective serum and urinary concentrations and osmolality were different from each other in the other groups. Analysis of urine provides a useful diagnostic tool in ARF of vascular origin. When urinary concentrations of sodium, urea and creatinine are similar to those in serum and FENa approaches 100%, the strong likelihood of total ARAO should be acknowledged, and renal arteriography is mandatory.

Acute Kidney Injury↗